| Objective:To analyze the diagnostic value of T1W/WATS/FFE enhanced scan, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) for pancreatic carcinoma. To explore the sensitivity and specificity of single T1W/WATS/FFE enhancement, DWI and combined of the two methods for the diagnosis of pancreatic carcinoma, and to compare the value of diagnostic validity. Methods:Routine MRI sequences, DWI and T1W/WATS/FFE enhancement were performed in 37 patients with pancreatic carcinomas (28 cases in the head,3 cases in the neck,6 cases in the body and empennage) and 32 healthy volunteers by 1.5 T MRI.①For T1W/WATS/FFE enhanced scan:calculate the signal enhancement ratio (SER) in each phase (arterial phase, parenchymal phase and portal phase) of normal pancreas and pancreatic carcinomas. The SERs of three phase in normal pancreas and the SERs of three phase in pancreatic carcinomas were treated with one way aonva; the SERs of three phase were treated with independent-samples t test in normal pancreas and pancreatic carcinomas. ROC curves drawn were used to decide the best diagnostic threshold to evaluate diagnostic validity, and to obtain the sensitivity, sensitivity and accuracy in the diagnosis of pancreatic cacinoma.②For DWI:the ADC value of pancreatic carcinomas, pericancerous tissue and normal pancreas were measured in pancreatic carcinomas, then analyzed with one way aonva. ROC curve was used to decide the best diagnostic threshold to evaluate diagnostic validity, and to obtain the sensitivity, sensitivity and accuracy.③Combined of the T1 W/WATS/FFE enhanced scan and DWI for diagnosing pancreatic carcinoma, to compare their diagnostic validity. Result:①Normal pancreas showed fast-up-and-down enhancement, SER of parenchymal phase was maximum; pancreatic carcinoma showed slow-up enhancement, arterial phase and parenchymal phase showed slight enhancement, SER of portal phase was maximum. The differences of SER in three phase between normal the pancreas and the pancreatic carcinoma were statistically significant. The best diagnostic threshold in parenchymal phase (SER=28.253%) for diagnosing pancreatic carcinoma, the sensitivity and specificity were 100%; the sensitivity and specificity were minimum in portal phase.②The mean ADC value of pancreatic carcinoma, pericancerous tissue and normal pancreas was(1.470±0.188)×10-3 mm2/s, (1.571±0.175)±10-3 mm2/s and (1.683±0.169)×10-3 mm2/s, respectively, ADC value of each them was statistically significant different through one way aonva (F=12.207, P<0.01). Which the best diagnostic threshold (ADC value=1.503×10-3 mm2/s) for diagnosing pancreatic carcinoma, its sensitivity and specificity were 78.38%,87.50% respectively. ③Combined of the T1W/WATS/FFE enhanced scan (portal phase) and DWI for diagnosing pancreatic carcinoma, for parallel test:the sensitivity and specificity was 96.49%,79.2% respectively; for serioal test:the sensitivity and specificity was 65.67%,98.93% respectively. Conclusion:①T1W/WATS/FFE enhanced scan could reflect the enhanced characteristic of pancreatic carcinoma and normal pancreas, measuring the SER of each phase contributes to diagnosing pancreatic carcinoma.②ADC value of pancreatic carcinoma was significantly different from that of the normal pancreas, measuring the ADC value contributes to diagnosing pancreatic carcinoma.③The best diagnostic threshold applied by the SER in T1W/WATS/FFE enhanced scan and the ADC value in DWI for diagnosing pancreatic carcinoma had above average diagnostic value.④The combination of T1W/WATS/FFE enhanced scan and DWI was more diagnostic validity than only the other diagnosis examination in sensitivity, specificity. |
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